Catherine Shea

About Catherine Shea

Managed Care Contracting and Payor Relations Executive with over 10 years of experience in securing high-value contracts, optimizing reimbursement strategies, and fostering collaborative partnerships across diverse healthcare models to drive revenue growth and operational efficiency.How I drive growth-Secured $20.4M+ in 12-month MCO revenue by leading contract negotiations that resulted in the execution of 31 new contracts with favorable reimbursement rates and terms-Achieved MCO revenue growth from $71.8M+ in 2019 to $97.4M+ by the end of 2021. The boosted the MCO revenue by $25.5M+ during the unprecedented COVID-19 Pandemic through an innovative and meticulously crafted strategy and rate adjustments-Directed 8 week facility projects that revitalized financial under performers by analyzing strengths, weaknesses, opportunities, and threats to create impactful market recovery plans.My Strategic Partnerships-Fostered strong relationships with stakeholders by shifting from transactional interactions to collaborative partnerships with MCO\'s, ICO\'s, CIN\'s, SNP and Government organizations-Developed and meticulously implemented comprehensive Payor contracting strategies across various models including VBC, MGD MCD, FFS, Commercial, MCR Advantage, SNP, and ACO Reach-Built strategic relationships with key stakeholders, cultivating a robust network that effectively lowered or displaced both cost and quality risks for episodes of care-Partnered with leadership, corporate teams, and regional staff to effectively oversee the administration and governance of managed care contracts, processes, and operational standards.Innovative Contract Negotiations-Negotiated highly favorable terms with MCR Advantage, Commercial, SNP, VA, and VBC effectively driving increased access to essential care for patients across multiple states-Instituted a comprehensive and effective Payor Relations infrastructure that refocused departmental efforts on vision-driven strategies for optimal rate and volume performance-Identified contract negotiation opportunities to enhance growth through value based agreements-Redesigned the contract roll-out process for greater efficiency with on-demand tools.

Experience

1. Strategic Partnerships & Payor Relations

   Frontline Management

   Jul 2025 — Present · Lafayette, CO, US

   Spearheaded the development of the Payor strategy to enhance financial success and strategic partnerships. • Managed contract negotiations and the entire contract life cycle, ensuring compliance and operational optimization. • Conducted reimbursement analysis and market intelligence to support decision-making and stakeholder engagement.

Skills

• Strategic Planning
• Management
• Team Building
• Medicare
• Marketing Strategy
• Hospitals
• Leadership
• Sales Management
• Hipaa
• Customer Service
• Managed Care
• Healthcare
• Healthcare Management
• Team Leadership